News & Analysis as of

Final Rules Patient Protection and Affordable Care Act (PPACA)

Saul Ewing LLP

Trump on Transparency: Making America Healthy Again Through Executive Order 14221; How Plan Sponsors Can Respond

Saul Ewing LLP on

One mandate under the PPACA required health care providers, non-grandfathered health insurance issuers and self-insured group health plans to provide consumers with access to information about the cost of services before they...more

Sheppard Mullin Richter & Hampton LLP

May the Coverage Be With You: Navigating CMS’s Changes to the Health Insurance Marketplace

The Department of Health and Human Services (“HHS”) Centers for Medicare & Medicaid Services (“CMS”) recently issued the final “HHS Notice of Benefit and Payment Parameters for 2026” (hereinafter referred to as the “Rule”)...more

Kaufman & Canoles

Medicare’s 60-Day Rule

Kaufman & Canoles on

The Centers for Medicare & Medicaid Services (CMS) finalized significant updates to the Medicare 60-Day Rule, which governs how providers and organizations must handle overpayments. Taking effect January 1, 2025, these...more

McDermott+

Regs on the Menu for Rescission Under Budget Reconciliation

McDermott+ on

Over the next several weeks, both the Trump Administration and the 119th Congress will review the “menu” of Biden-era regulations that they may want to rescind or modify. In one of his first orders, President Trump (like...more

Davis Wright Tremaine LLP

Stay ADvised: 2025, Issue 3

FTC's Final Junk Fees Rule Narrowed in Scope - On December 17, 2024, the Federal Trade Commission (FTC) released its final Rule on Unfair or Deceptive Fees, commonly known as the "Junk Fees Rule." This final rule has a...more

Holland & Knight LLP

OCR Shores Up Access to Healthcare with Nondiscrimination Protections

Holland & Knight LLP on

Access to quality healthcare services has long been a priority of the U.S. Department of Health and Human Services (HHS), and through its Office for Civil Rights (OCR) this agency has, since at least 2001, sought to provide...more

McDermott Will & Emery

HHS Letter Reiterates Expectations for Language Accessibility

McDermott Will & Emery on

On December 5, 2024, the US Department of Health and Human Services (HHS) Office for Civil Rights (OCR) issued a “Dear Colleague” letter reiterating obligations that covered entities have under the May 2024 final rule related...more

Ropes & Gray LLP

CMS Issues Final Rules for Medicare Parts A and B Overpayments: Key and Lingering Questions

Ropes & Gray LLP on

In November 2024, the Centers for Medicare & Medicaid Services (“CMS”) released a final rule addressing, among other things, the Medicare Parts A and B overpayment provisions of the Affordable Care Act (the “Final Rule”). It...more

King & Spalding

The Trifecta: What to Expect from a Second Trump Administration and a Republican Congress

King & Spalding on

Republicans have swept the 2024 elections, returning Donald Trump to the White House as the 47th President and flipping the Senate to a Republican majority. Having narrowly maintained control of the House of Representatives,...more

Goodwin

Watch the Clock! CMS Makes Important Changes to Medicare Overpayment Rules

Goodwin on

The Centers for Medicare & Medicaid Services (CMS) recently made meaningful changes to its regulations interpreting the Affordable Care Act’s (ACA’s) so-called “60-day Rule,” which requires Medicare providers to affirmatively...more

Robinson+Cole Health Law Diagnosis

CMS Finalizes Standard for Identifying Overpayments and Grace Period for Investigations of Related Overpayments

As part of its 2025 Physician Fee Schedule Final Rule (PFS Rule), the Centers for Medicare & Medicaid Services (CMS) finalized two crucial updates to federal Medicare overpayments regulations (sometimes referred to as the...more

King & Spalding

CMS Makes Modifications to the Medicare Shared Savings Program

King & Spalding on

In its Final Rule for the 2025 Medicare Physician Fee Schedule, CMS announced changes to the Medicare Shared Savings Program (the Program) targeted at incentivizing providers to both enroll and stay in the Program. The Final...more

Holland & Hart LLP

Are You Ready for It? Section 1557's Upcoming Deadlines

Holland & Hart LLP on

The Department of Health and Human Services (“HHS”) Office of Civil Rights (“OCR”) published its final rules implementing the anti-discrimination provisions under Section 1557 of the Affordable Care Act (“Final Rule”) on May...more

Proskauer - Employee Benefits & Executive...

Deadlines Approaching for New ACA Section 1557 Nondiscrimination Requirements: Action Items for Covered Group Health Plans

Earlier this year, the Department of Health and Human Services (“HHS”) released a final rule under Section 1557 of the Affordable Care Act (“ACA”), which prohibits discrimination in health programs and activities. The 2024...more

Bricker Graydon LLP

Mental Health Parity and Addiction Equity Act (MHPAEA) Final Regulations Have Been Issued

Bricker Graydon LLP on

If you are a state or local government that sponsors a “self-funded” employee group health plan instead of using an insurance provider, you had previously been allowed to “opt out” of compliance with the following four...more

Seyfarth Shaw LLP

What To Do When Your Healthcare Employee Objects To Providing Treatment Based on Religious Grounds

Seyfarth Shaw LLP on

Seyfarth Synopsis: With the myriad claims for religious accommodation that came out of mandatory COVID vaccination policies, employers have become familiar how to handle requests for religious accommodation in the workplace. ...more

Bricker Graydon LLP

AI and Healthcare: Decoding the Latest 1557 Non-Discrimination Regulations

Bricker Graydon LLP on

Section 1557 of the Affordable Care Act (ACA) prohibits providers and health plans that receive reimbursement from the federal government from discriminating against individuals in the Covered Entities’ health programs. Such...more

Proskauer - Health Care Law Brief

OIG Reports that Clinical Trials Lack Diverse Subjects: What Role Can Artificial Intelligence Play?

As the largest public funder of biomedical research in the world, the National Institutes of Health (“NIH”) annually funds over $38 billion in extramural research, including about $6 billion for clinical trials. On May 28,...more

McDermott Will & Emery

The Impact of the ACA 1557 Final Regulations on Gender-Affirming Care

Section 1557 of the Affordable Care Act (ACA) prohibits discrimination on the basis of race, color, national origin, sex, age or disability, or any combination thereof, in a health program or activity, any part of which is...more

Lippes Mathias LLP

HHS Issues Final Rule to Expand Discrimination Prohibition in Health Care Services

Lippes Mathias LLP on

The U.S. Department of Health and Human Services (“HHS”) Office for Civil Rights (“OCR”) and the Centers for Medicare & Medicaid Services (“CMS”) issued a final rule on May 6, 2024 (the “Final Rule”) under Section 1557 of the...more

McDermott Will & Emery

The ACA 1557 Final Regulations: Plans and Plan Sponsors as Covered Entities

McDermott Will & Emery on

In a recent On the Subject (available here), we reported on the impact of the final rule (final rule) interpreting Section 1557 of the Affordable Care Act (ACA) on self-funded group health plans that contract with licensed...more

Seyfarth Shaw LLP

Does Section 1557 Apply to Employer Group Health Plans? (And — Why That Question May Not Even Matter)

Seyfarth Shaw LLP on

Seyfarth Synopsis: Following years of back and forth, new final rules were published by the Department of Health and Human Services (HHS) on May 6, 2024 reinstituting the Department’s interpretation that the prohibition on...more

Sheppard Mullin Richter & Hampton LLP

DHHS Bolsters Non-Discrimination Protections for Recipients of Covered Health Care Services and Activities

In a Final Rule issued on May 6, 2024, the U.S. Department of Health and Human Services (“DHHS”) finalized regulations implementing Section 1557 of the Affordable Care Act (“Section 1557”). The Final Rule updates and...more

Bass, Berry & Sims PLC

Gender-Affirming Care Remains a Hot Topic in 2024

Bass, Berry & Sims PLC on

Our April 9 blog post highlighted several issues to watch during 2024, one of which was gender-affirming care considerations. Just over a month later, there have now been three key developments with respect to that issue:...more

Mintz - Health Care Viewpoints

340B Program Administrative Dispute Resolution Final Rule: Key Takeaways

On April 18, 2024, the U.S. Department of Health and Human Services (HHS) Health Resources and Services Administration (HRSA) released a new Final Rule for its oft-criticized 340B Administrative Dispute Resolution (ADR)...more

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